Outcomes and Economic Benefits of Penn State Extension's Dining With Diabetes Program.

INTRODUCTION: Many diabetes education programs address the problem of diabetes, but little attention is given to the economic impact of such programs. Our objective was to assess the effectiveness of a community-based education program in improving diabetes-related lifestyle behaviors and biomarkers and ascertain the economic benefits of the program for adults aged 18 years or older with type 2 diabetes, prediabetes, or no diagnosis of diabetes in Pennsylvania. METHODS: From October 2012 through June 2015, Pennsylvania State University Extension's Dining with Diabetes program collected data on 2,738 adults with type 2 diabetes or prediabetes and adult family members without diabetes. The program consisted of 4 weekly 2-hour classes and a follow-up class conducted 3 months after the fourth 2-hour class. In the initial class and the follow-up class, participants completed a lifestyle questionnaire and their hemoglobin A1c and blood pressure were measured. Economic benefit was calculated as the medical expenditure cost savings resulting from program participation. RESULTS: At 3-month follow-up, a significant number of participants had improved their lifestyle behaviors (diet and physical activity), had reductions in hemoglobin A1c and blood pressure, and improved their diabetes status. The Dining with Diabetes program had a 5-year benefit-cost ratio of 2.49 to 3.35. CONCLUSION: Participants who completed the Dining with Diabetes program had significant improvements in diabetes-related biomarkers and lifestyle behaviors. If the Dining with Diabetes program were extended to half of the 1.3 million people living with diabetes in Pennsylvania and if they had similar improvements, the 1-year benefit to the state would be approximately $195 million, assuming a conservative 15% decrease in direct medical costs.

Impact of preparing for OSHA local emphasis program inspections of New York dairy farms: Case studies and financial cost analysis.

BACKGROUND: OSHA inspection of dairy farms began in July 1, 2014 in New York State. As of September 2014, a total of eight farms were randomly selected for inspection. This case study addresses how dairy farm managers prepared for these inspections, and identifies farm level costs preparing for inspection and/or being inspected. METHODS: Four farms that were OSHA inspected and 12 farms that were not inspected were included in this mixed method evaluation using a multimodal (telephone, email, or mail) survey. Descriptive analysis was carried out using frequencies, proportions, means, and medians. RESULTS: Overall, the impact of OSHA inspections was positive, leading to improved safety management and physical changes on the farm and worker trainings, although the farmers' perspectives about OSHA inspection were mixed. CONCLUSIONS: The cost of compliance was low relative to estimated overall production costs. Clarifications and engineering solutions for specific dairy farm hazard exposures are needed to facilitate compliance with OSHA regulations.